Category Archives: Infectious Disease

This edition of Straight, No Chaser is a keepsake, whether for your own reference or as a conversation piece/teaching guide for others. I suspect that due to the volume and wealth of information contained within, you’ll refer to this post time and again (or so I hope). For additional information, refer to the U.S. Center for Disease Control and Prevention and/or the National Institutes of Health websites.

STAYING STD-FREE

The best ways to stay STI free is to confirm it and then avoid it. If you want to reduce your risk of acquiring HIV and other STIs (sexually transmitted infections) through sexual contact, here are your options.

Abstain from sex.

Be monogamous.

Prove both you and your partner(s) are negative. Get yourself and your partner(s) tested, preferably prior to engaging in sexual activity and subsequently every three to six months, especially if you and/or your partner have more than one sexual partner.

If and once you establish that you’re STI-free, learn how to use condoms and do so every time you have sex.

A special note about protecting yourself from HIV

HIV can be spread by having unprotected sexual contact with an HIV-positive person. “Unprotected” means any vaginal, anal or oral sex without barrier protection, like a condom or dental dam. Some of the ways to reduce your risk of getting HIV through sexual contact include the following:

Don’t have sex. Abstinence is the best way to be certain that you won’t contract HIV. Although HIV is occasionally transmitted in other ways, vaginal, anal and oral sex are the most common ways that HIV is transmitted.

Be monogamous. To be clear, this means you are in a sexual relationship with only one person and both of you are having sex only with each other. For the purposes of contracting HIV, sex includes vaginal, oral or anal sexual activity. Monogamy is optimally effective if you also confirm early and often that both you and your partner are not infected with HIV.

Get yourself and your sexual partner(s) tested: Knowing your own status is important for both your health and the health of your partner. Talking about your HIV status likely will be difficult and uncomfortable, but it’s important to start the discussion BEFORE you have sex.

FRANKLY, “DON’T ASK, DON’T TELL” IS JUST DUMB WHEN IT COMES TO STIs.

This is actually quite simple. No excuses. You need to ask your sexual partner(s) and any possible future partners the following questions.

Have you been tested for HIV, herpes, gonorrhea, syphilis and/or chlamydia?

When was the last time you were tested for HIV, herpes, gonorrhea, syphilis and/or chlamydia?

If you’ve been tested, what were the results of your tests?

SAFER-SEX ACTIVITIES
These activities carry no risk of HIV transmission:

Non-sexual massage

Casual or dry kissing

Masturbation (without your partner’s body fluids)

Frottage—also known as “dry humping” or body-to-body rubbing

You can still contract other STIs, like herpes, HPV, or pubic lice (“crabs”) if you have bare skin-to-skin contact with your partner.

CONDOM USE

Here are two questions for both males and females.

Have you ever learned how to safely and appropriately use condoms?

Do you use condoms consistently?

To maximally reduce your risk of getting HIV or other STIs, you must use a new condom with every act of vaginal, anal or oral sex. If you don’t use them for oral but do for vaginal and anal, you have still lowered your risk, just not as much as you could have. Also, you must use condoms correctly, as depicted in the above diagram, to appropriately reduce your risk. Learning correct usage also will keep condoms from breaking or slipping off, which reintroduces the risks.

I also want you to understand that all condoms are not created equal. Latex condoms are highly effective against HIV and other STIs. Do you or your partner have a latex allergy? If so, the next safest condom choice is a polyurethane or polyisoprene condom. Just tell your pharmacist at the drug store that you’re allergic to latex, and s/he’ll take it from there. On the other hand, lambskin condoms do NOT protect against HIV. The particle size of the virus allows it to maneuver and slip through lambskin.

Condoms alone have never been enough. Did you know that you should always use a water-based lubricant when you use a condom for either vaginal or anal sex? I want to restate this: that’s water, not petroleum jelly. Water-based lubricants reduce friction and help keep the condom from breaking. Do NOT use an oil-based lubricant (such as petroleum jelly, hand lotion or cooking oil). Oil-based lubricants can damage condoms, making them less effective.

Both male condoms and female condoms will help protect you against HIV and other STIs. If you’ve learned to enjoy sex with a male condom, you can learn to enjoy it with a female condom or a dental dam. Additionally, there are many of you who have contracted STIs. If you wish to continue to enjoy a variety of sexual activities, learning to use the full range of barrier protection may be a better option for you and your partner than abstaining.

Condoms do not provide 100% protection against all STIs, but you are always safer using a condom than not. You can get certain STIs, like herpes or HPV, from contact with your partner’s bare skin, even if one of you is wearing a condom, but condoms lessen the risk. Take the time to explore and inspect each other if you’re confused or concerned about the possibility of your partner having an STI.

Spermicides only serve the purpose of reducing the risk of becoming pregnant. They are ineffective in preventing contraction of HIV and other STIs. They actually irritate rectal and vaginal walls, in effect increasing the chances of HIV infection, should infected fluids come into contact with these areas.

ABOUT SEX TOYS

This is pretty straightforward. Using sex toys can be safe, but think of staying clean and “not sharing.”

It is important that you use soap and water to clean your toys after each use. If the instructions allow for a stronger disinfectant, you may do so.

As a rule, don’t share your toys. The nature of how toys are typically used likely increases the risk of vaginal or anal irritation, which increases the risk for HIV or other STI transmission.

If you “must” share your toy with your partner while still trying to be safe, use a condom on the toy before you use it, and change the condom before your partner uses it.

CIRCUMCISION
We’ve discussed circumcision at length in Straight, No Chaser. (Click here for a dedicated post on circumcision.) There has been ongoing interest and research over the past few years about circumcision and its effect on preventing HIV infection. The bottom line? In 2007, the World Health Organization reported that male circumcision reduced the transmission of HIV by 60% from women to men in three randomized, controlled studies in Uganda, Kenya, and South Africa.

There is much less available data for men who have sex with men and how circumcision might affect HIV transmission through anal sex. In addition, recent studies show that circumcision does NOT protect women from contracting HIV from male partners.

Let’s be careful in interpreting the results of these findings.

Circumcision is only additionally effective when earlier preventative efforts have not been taken. Advocating circumcision is not an appropriate substitute for any of the numerous safety measures and habits previously discussed to reduce one’s risk for HIV and other STIs.

Failure to have a circumcision does NOT increase one’s HIV and other STI risk in the presence of appropriate safe-sex activities.

So there you have it. Knowledge is power. We appreciate that this posting was not balanced by the human decisions and passions that come into place with sexual activity. We recommend that you adopt a posture of “safety first” to create that balance! Good luck, and feel free to ask your SMA expert consultant any questions you may have on this topic.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

January is Cervical Health Awareness Month, and to that end, The Center for Disease Control and Prevention (CDC) boldly proclaims “No woman should die of cervical cancer.”

It’s cervical health month in the United States, and this point has a rather simple message: Cervical cancer is highly preventable and can be cured when discovered and treatment early. Here are some quick tips to help you check this off of your list of concerns.

Every child should get vaccinated at age 11 or 12. Even if you’ve reached age 26 and haven’t been vaccinated, you should discuss options with your physician.

The most important thing you can do to help prevent cervical cancer is to get screened regularly starting at age 21.

The Pap test (or smear) should be performed regularly at age 21. It looks for precancerous changes to the cervix that identify the need for early treatment. In many cases a normal test will eliminate the need for another test for the next three years, but your physician will discuss your individual circumstances in this regard.

The HPV test looks for the virus that is now known to be the cause of cervical cancer. Furthermore, human papillomavirus (HPV) is sexually transmitted. The HPV test can be done at the same time as the Pap test from the same examination.

Hopefully knowing these simple tools will convince you to be attentive to preventing and managing your cervical health. This is a public health success story in that cervical cancer could be eliminated if everyone followed the above steps. The rest is up to you.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

At some point, you’ve got to be on board with the notion that you need to prevent some of the things that ail you. All men who have UTIs are at higher risk for having another one. About one of every five women who have a UTI will have another one. Many women have three or more UTIs a year. This Straight, No Chaser will address preventative and treatment considerations for urinary tract infections. Check back to thisStraight, No Chaser for a discussion of the how and why you get UTIs.

Some individuals have unfortunate anatomy, and others have increased risk factors due to diseases (e.g. diabetes) or a lowered immune system. Even in these individuals, improving daily habits and lifestyle choices may help you prevent repeat UTIs. There actually is a fair amount of controversy regarding methods of preventing and treating UTIs. The information I am providing represents the latest consensus information from the U.S. Department of Health and Human Services.

Fluids

Drinking lots of fluid (preferably water) can help flush bacteria from your system. Unless you have kidney or heart failure, you should try to drink six to eight, 8-ounce glasses a day.

Regarding cranberries and cranberry juice, the jury is still out. This is what we do know: there is a substance in cranberries that assist in preventing bacteria from sticking to the walls of your urinary tract. The ability to attach to the walls of your urinary tract keeps bacteria from being flushed out and allows them to grow and multiply. It seems that the amount of this substance in the typical glass of cranberry juice you’re drinking or serving of cranberries you’re eating is sufficient to completely prevent or treat UTIs. It is more likely that the benefit you’re receiving simply comes from drinking fluids. The bottom line? Drinking cranberry juice isn’t hurting you and may be helpful.

Bathroom Habits

It’s just a good idea to urinate often. Whenever you feel the urge, and it’s convenient, eliminate the waste. Also, make a habit of urinating after sex, as soon as it’s convenient. These steps prevent bacteria from staying in your bladder longer than necessary, preventing the growth that can become a UTI.

It’s true: always wipe from front-to-back after using the toilet. A back-to-front wipe can deliver bacteria straying from the rectum (and inclined to cause a UTI) close enough to your urethral opening to get things started.

Birth Control

Using a diaphragm or spermicide increases bacteria growth and can lead to UTIs. If you’re not having an issue with this, that’s fine, but if you are, you may want to consider a different form of birth control. Furthermore, unlubricated or spermicidal condoms increase irritation of the vaginal walls, which may help bacteria grow and may lead to transport up the urinary tract. This is yet another reason why lubricated condoms without spermicide or a nonspermicidal lubricant are better options for safe sex.

Clothing

Does wearing cotton underwear and loose-fitting clothes prevent UTIs? Probably not. Does doing so keep the area around the urethra dry? Yes. Nylon underwear and tight-fitting jeans can trap moisture and help bacteria grow. Use this information to your advantage. This is another example of how altering your habits may help and won’t hurt the cause.

Instrumentation

Whether you’re a patient using a catheter to assist yourself with emptying your bladder, or if you’re placing objects into your genital orifices for other purposes (e.g. sexual stimulation), you should appreciate the risks found in not exercising good hygiene with these objects. The immediate proximity of these objects to your urinary tract certainly increases the risks of UTIs.

Treatment

Treatment is usually straightforward and based on the eliminating the organisms most likely to be causing the infection. Treatment regimens range from 3 days to more than a week depending on certain considerations such as severity, resistance patterns in your area, whether you get frequent UTIs and whether you have certain risks or anatomical abnormalities in your urinary tract. Men should receive a longer course of treatment as a rule due to the involvement of the prostate.

Other treatment considerations involve pain control and plenty of fluids.

If your frequency or severity of UTIs requires as much, you may be referred to a urologist for specialized treatment considerations. However, for most people, this isn’t necessary because treatment is sufficient – and prevention is even easier.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Ladies, have you ever been told that you get “bladder infections” because you didn’t wipe front to back instead of back to front? Men, have you ever been told that this could be a sign that your prostate needs to be examined? This Straight, No Chaser answers simple questions on urinary tract infections (UTIs). With over 8 millions cases and 100,000 hospitalizations a year due to these, it’s information you should know.

What is a urinary tract infection (UTI)? Is it the same as a bladder infection?

What these questions really ask is “What is the urinary tract?” The body’s drainage system serves to remove excess fluid and bodily waste. It includes the following organs:

The kidneys serve to filter blood and produce approximately 1-2 quarts of urine per day as a result of this process.

The ureters are tubes extending from the kidneys to the bladder, carrying filtered urine within them.

The bladder is the pouch within which you store urine until you’re ready to release it.

The urethra is a tube at the bottom of the bladder through which urine gets expelled.

A UTI is an infection anywhere along this path. Infections at different parts of the urinary tract can display different symptoms and have different complications.

What causes a UTI?

Bacteria are the most common cause of UTIs, particularly those that live in the bowel (such as E. coli) and are within or in close proximity to the vagina. Under most circumstances the body is very effective at removing bacteria and other microorganisms from the urinary tract (urinating just washes them out!), but some of us are at increased risk due to diminished defenses or other circumstances in which these microorganisms can grow.

Why do women get UTIs, and it seems like men don’t?

It is true that women get UTIs about four times more frequently than men, but anyone of any age or sex can be infected. Here are some reasons why.

Women have a shorter urethra, which makes it easier for bacteria to reach the bladder.

Also, the opening of a woman’s urethra is near the vagina and anus, where bacteria live.

Women who use a diaphragm are also more likely to get UTIs than women who use other forms of birth control.

The male prostate produces secretions that slow bacterial growth.

Are there other risk factors for UTIs?

Yes. Others at higher risk for UTIs include the following.

those having diabetes or have lowered immune systems

those habitually needing a tube to drain their bladder

those with urinary tract abnormalities that block the flow of urine

those with spinal cord injuries or other nerve damage

Additionally, once a man has a UTI, it’s more likely he’ll have the problem again because the bacteria are extremely difficult to reach once they set up shop in the male prostate.

Are UTIs serious?

Unless you describe the annoying symptoms as serious, most UTIs are not serious. However, UTIs can lead to severe complications if left untreated, including the following:

Long lasting or recurrent kidney infections can cause permanent damage and scarring to the kidneys, which can create insufficient kidney function and produce high blood pressure and other problems.

Kidney infections can enter the blood stream and become life threatening.

What are the signs and symptoms of a UTI?

You should see your physician if you develop any of the following signs or symptoms:

A burning sensation with urination

Bloody, cloudy, dark or otherwise discolored urine

Fever or chills

Foul-smelling urine

Frequent or urgent need to urinate, regardless of the amount actually expressed

Pain in your back or side below the ribs

How are UTIs diagnosed?

UTIs are diagnosed based both on symptoms and a lab test. Many of you have experienced your urine being sent to a lab from the emergency room or your doctor’s office. Based on a combination of symptoms, the presence of bacteria and white blood cells that have accumulated to fight the infection, the diagnosis will be made. If you have frequent infections, infections that don’t respond well to treatment, atypical presentations or are sick enough to be hospitalized, your urine may be cultured in an effort to grow the bacteria causing your symptoms. This allows more precise treatment regimens to be given. In other circumstances, tests may be done to check the normalcy of your urinary tract, including an ultrasound or CT scan. Further details on when and why this would be done is available on www.sterlingmedicaladvice.com.

An additional Straight, No Chaser will discuss prevention and treatment options for UTIs.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

The vomiting, diarrhea, fever, abdominal cramps and all around bad feelings you may get with food poisoning is extremely unpleasant. We’ve previously discussed preventative measures you can take to minimize your risks, but you should also want to know what measures to take in the event you actually develop food poisoning. Of course, with over 250 different illnesses related to various forms of food poisoning, there’s a wide variety of treatment, some of which means to treat the specific disease (and its cause) and others that only treat the symptoms.

I always tell patients that although the vomiting and diarrhea are dramatic nuisance symptoms, the real concern is the risk of dehydration from these fluid losses. Given the body is approximately two-thirds water, altering that balance can lead to disturbances of many of the body’s functions and increase the risk of more serious infections. Thus the key to treatment is staying ahead of fluid and electrolyte losses that occur. Perhaps you’re wondering “How can I do that if I’m vomiting?” Here are five very important principles for you to remember.

First things first: if you have severe diarrhea, your favorite sports drink is not the cure. The composition of fluids and electrolytes in your stool is different from in your sweat, so these drinks don’t optimally replace your losses.

I want you to become familiar with oral rehydration therapy/solution (ORT). It’s how most of the rest of the world first treats fluid losses from vomiting and diarrhea. You may have heard of Ceralyte, Oralyte or Pedialyte, all of which are examples. ORT represents the best possible fluid for you to take and is readily available without a prescription at your local pharmacy or grocery store.

Here’s the deal with staying hydrated: you can’t hold a lot on your stomach. You need to dial back as much as possible so that you can tolerate something. That’s why you sip on chicken soup instead of steak when you’re sick. You’re likely to have more success keeping down teaspoons of fluid at a more frequent interval (say, every few minutes) than trying to chug a lot of fluid all at once.

Preparations of bismuth subsalicylate (Pepto-Bismol is a common example) can reduce the duration and severity of simple diarrhea.

If you have diarrhea and cramps with a fever or bloody stools, you should not take antidiarrheal medication without an evaluation by a physician. Even if they make you feel better, these medicines can make your food poisoning much worse.

Here’s one other point that you should understand as you’re going into your doctor’s office or the emergency room: don’t expect to receive an antibiotic to treat your vomiting and diarrhea. Most of these episodes are caused by viruses, which are self-limited and will resolve within two to three days. Furthermore, viruses don’t respond to antibiotics. In fact, efforts to use antibiotics in many of these cases only contribute to antibiotic resistance later on when you actually need them. Antibiotic resistance is discussed in detail in this Straight, No Chaser post.

Finally, here are symptoms that should prompt you to see your physician.

Bloody stools

Diarrhea lasting more than 3 days

High fever (oral temperature over 101.4 F)

Signs of dehydration, such as a decrease in urination, a dry mouth and throat, and dizziness with standing

Vomiting with inability to keep down liquids

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Those of you who are regular readers of Straight, No Chaser may have heard me say that everything you place in your mouth either harms or helps you. Your mouth is the direct point of entry to your body. You should be concerned about the substances you ingest. Today’s post begins a Straight, No Chaser series that will discuss food safety, food poisoning, prevention and treatment of food borne illnesses – just in time for you to correctly handle all of those holiday leftovers! Today we start with food safety.

Allow me to suggest that bacteria are as much (if not more) of a part of this world as humans, and it is to be expected that they would be present in our food supply. Our issues are when does present become contaminated, and when does contaminated become illness? Understanding these issues makes it easier to take appropriate preventative and treatment measures when needed.

Here are some examples of how our food becomes contaminated.

Microorganisms (e.g. bacterial, viruses) exist in the intestines of healthy animals, even those raised for human consumption. Even a small amount of spillage of intestinal contents during slaughter can lead to contamination.

Fruits and vegetables can be contaminated when washed or irrigated with contaminated water (which sometimes contains animal manure or human sewage).

Salmonella can infect a hen’s ovary (remember the ovaries produce eggs) so that the contents of a normal-appearing egg can be contaminated even before the shell is formed.

Vibrio bacteria are normally present in seawater. Oysters and other shellfish can develop concentrations of Vibrio high enough to cause infections.

Microorganisms such as norovirus can concentrate in human sewage that is dumped into the sea. This contaminates the water supply.

Infected food handlers and food conditions pass microorganisms on to customers. Examples of this include Shigella bacteria, hepatitis A virus and norovirus. Knives, other utensils and table surfaces also are methods of transferring disease when unclean.

When certain foods are left out (i.e. not refrigerated), minimal contamination can become highly infectious in a matter of hours due to rapid growth of microorganisms. Conversely, in most instances refrigeration or freezing prevents virtually all bacteria from growing. Certain other foods (e.g. salted meats, jams, pickled vegetables) require high salt, sugar or acid levels to prevent bacterial growth.

When certain foods are adequately cooked (the ideal internal temperature is 160 degrees Fahrenheit), most microorganisms will be killed.

Protecting yourself from foodborne illness

Professionals in public health, industry, governmental regulatory agencies, and academic research have roles to play in making the food supply less contaminated. So do you. I would like to advocate for one simple step for you to take as you shop for food that will promote food safety.

Buying pasteurized milk rather than raw unpasteurized milk prevents an enormous number of foodborne diseases every day and has done so for 100 years. Juice pasteurization has more recently proven to be important in preventing certain E. coli infections. Basically, you can lower your risk by purchasing pasteurized products.

Courtesy of the Centers for Disease Control and Prevention, here are some additional simple precautions to reduce the risk of foodborne diseases:

COOK: Cook your meat, poultry and eggs thoroughly.

Using a food thermometer to measure the internal temperature of meat is a good way to be sure that it is cooked sufficiently to kill bacteria. Remember, the internal temperature of meat should be above 160 degrees Fahrenheit.

Eggs should be cooked until the yolk is firm.

SEPARATE: Don’t cross-contaminate one food with another.

Avoid cross-contaminating foods by washing hands, utensils and cutting boards after they have been in contact with raw meat or poultry and before they touch another food.

Put cooked meat on a clean platter, rather back on one that held the pre-cooked, raw meat.

CHILL: Refrigerate leftovers promptly.

Bacteria can grow quickly at room temperature, so refrigerate leftover foods if they are not going to be eaten within 4 hours.

Large volumes of food will cool more quickly if they are divided into several shallow containers for refrigeration.

CLEAN: Wash produce.

Rinse fresh fruits and vegetables in running tap water to remove visible dirt and grime.

Remove and discard the outermost leaves of a head of lettuce or cabbage.

Because bacteria can grow well on the cut surface of fruit or vegetable, be careful not to contaminate these foods while slicing them up on the cutting board, and avoid leaving cut produce at room temperature for many hours.

Wash your hands with soap and water before preparing food and before touching others.

Avoid preparing food for others if you yourself have a diarrheal illness.

Changing a baby’s diaper while preparing food is a bad idea that can easily spread illness.

Calls from concerned citizens are often how outbreaks are first detected. Play your part.

If a public health official contacts you to find out more about an illness you had, your cooperation is important. In public health investigations, it can be as important to talk to healthy people as to ill people.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

The Straight, No Chaser vlog series presents “health care basics” to keep you safe, healthy and out of the emergency room. If you’ve been a regular or even an infrequent follower of Straight, No Chaser, you know we’ve had a lot to say on sexually transmitted infections (diseases). Today we revisit the topic because out of sight is not out of mind when it comes to these. So give us two minutes of your time, and let’s see if you’re up to speed with your healthy habits! Happy Holidays!

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!